title: More than half of the patients with acute Puumala hantavirus infection have abnormal cardiac findings.
abstract: This study was conducted to determine the frequency, severity and outcome of cardiac findings in patients with acute Puumala hantavirus-induced nephropathia epidemica (NE). 70 consecutive, hospital-treated patients with serologically confirmed NE were prospectively examined using serial electrocardiograms (ECG), plasma troponin I, tumour necrosis factor alpha (TNF-alpha), interleukin-6 (IL-6), and echocardiography (ECHO). Examinations were repeated after 3 and 12 months. ECG changes were observed in 57% of patients. Plasma troponin I levels remained normal in all. In six patients, ECHO showed left ventricular contraction abnormalities, and 1 patient had mild pericardial effusion. There were no differences in clinical or standard laboratory findings or in plasma TNF-alpha and IL-6 concentrations between patients with and without ECG or ECHO changes. During the follow-up, all acute-phase changes in ECG and ECHO reverted to normal, which probably reflects their benign nature. We conclude that abnormal cardiac findings are surprisingly common during NE.
authors.affiliation: Medical School, University of Tampere, Finland. satu.marjo.makela@uta.fi
authors.forename: Satu
authors.initials: S
authors.lastname: Makela
authors.forename: Liisa
authors.initials: L
authors.lastname: Kokkonen
authors.forename: Ilpo
authors.initials: I
authors.lastname: Ala-Houhala
authors.forename: Kaj
authors.initials: K
authors.lastname: Groundstroem
authors.forename: Aimo
authors.initials: A
authors.lastname: Harmoinen
authors.forename: Heini
authors.initials: H
authors.lastname: Huhtala
authors.forename: Mikko
authors.initials: M
authors.lastname: Hurme
authors.forename: Antti
authors.initials: A
authors.lastname: Paakkala
authors.forename: Ilkka
authors.initials: I
authors.lastname: Porsti
authors.forename: Vesa
authors.initials: V
authors.lastname: Virtanen
authors.forename: Antti
authors.initials: A
authors.lastname: Vaheri
authors.forename: Jukka
authors.initials: J
authors.lastname: Mustonen
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005387:Finland / Q000453:epidemiology; D006480:Hemorrhagic Fever with Renal Syndrome / Q000503:physiopathology* / Q000821:virology*; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000175:diagnosis / Q000453:epidemiology*; D029262:Puumala virus / Q000472:pathogenicity*; D012720:Severity of Illness Index; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult